DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BROCK SPARKS DPT

MEDICARE: BROCK SPARKS DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP21931NC

General Provider Information

NPI Number : 1528764172
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROCK SPARKS DPT
Provider Business Mailing Address
First Line : 100 KIMEL FOREST DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-6074
Country : US
Telephone Number : 336-716-2255
Fax Number :
Provider Business Practice Location Address
First Line : 1901 MOONEY ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-3027
Country : US
Telephone Number : 336-716-8091
Fax Number : 336-716-9253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2023
Last Update Date : 12/10/2025

Similar Medicare Providers

1053643395 — MATTHEW P ZWILLING
Practice Location Address:
1901 MOONEY ST
WINSTON SALEM, NC
27103-3027
Practice Phone: 336-716-8091
Practice Fax: 336-716-9253
1326615196 — SARAH DANIELLE PRICE
Practice Location Address:
1901 MOONEY ST
WINSTON SALEM, NC
27103-3027
Practice Phone: 336-716-8091
Practice Fax: 336-716-9253
1689405128 — JAMELL JOSEPH PT, DPT
Practice Location Address:
1901 MOONEY ST
WINSTON SALEM, NC
27103-3027
Practice Phone: 336-716-8091
Practice Fax: 336-716-9253
1942723267 — DR. MICHAEL BRENDAN VAUGHN PT, DPT
Practice Location Address:
1901 MOONEY ST
WINSTON SALEM, NC
27103-3027
Practice Phone: 336-716-8091
Practice Fax: 336-716-9253
1215569215 — DR. JESSICA JUDITH FRITSON PT, DPT, LAT, ATC
Practice Location Address:
1901 MOONEY ST
WINSTON SALEM, NC
27103-3027
Practice Phone: 336-716-8091
Practice Fax: 336-716-9253
1922691419 — ANDREW BENNETT LEE PRICE DPT
Practice Location Address:
1901 MOONEY ST
WINSTON SALEM, NC
27103-3027
Practice Phone: 336-716-8091
Practice Fax:

Directions to “ BROCK SPARKS DPT” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.